Data flaws jeopardize ObamaCare coverage for millions


Health and Human ServicesInconsistencies in application data submitted to online health care insurance exchanges may jeopardize coverage for millions of Americans and cause massive headaches come next tax season.

According to a new report from the Inspector General of the Department of Health and Human Services, the federal government was unable to resolve 89 percent of the “inconsistencies” in data from applications submitted at

“During the period of our review, marketplaces were unable to resolve most inconsistencies, which they reported most commonly as citizenship and income,” the report said. “Specifically, the Federal marketplace was unable to resolve 2.6 million of 2.9 million inconsistencies because the Centers for Medicare & Medicaid Services (CMS) eligibility system was not fully operational.”

Accurate data is required to ensure that applicants can verify their enrollment and, in some instances, obtain subsidies for their coverage. The problem could cause confusion when an applicant attempts to use their insurance and will almost certainly cause turmoil during the 2015 tax season.

According to the report, most of the problems revolved around verifying individuals citizenship and income information. In many cases, such information submitted by applicants conflicted with what the federal government had on record. The problems are only exacerbated by an eligibility system that the report said is not fully functional.

Although the problem is not known to extend to all state-based exchanges, similar difficulties have been reported in Massachusetts, Nevada, Oregon and Vermont.

The report also indicates that this new information may be incomplete, as “data on inconsistencies are limited.”

“For example, the Federal marketplace could not determine the number of applicants who had at least one inconsistency,” the report said. “[M]arketplaces faced challenges resolving inconsistencies despite having policies and procedures in place.”

“This report is one more example of just how flawed the president’s health care law is,” Senate Minority Leader Mitch McConnell (R-Kty.) said in a statement. “Whatever one’s opinion of ObamaCare, the American public deserves to know that their tax dollars are allocated appropriately and that public officials take their responsibility to accurately and faithfully apply the laws enacted by Congress seriously.”

Data inconsistency is just one of the problems incoming Health Secretary Sylvia M. Burwell will face as she takes over for Kathleen Sebelius, who resigned in April.

Read the full report here:


About Steve Robinson

Steve Robinson is the Editor-in-Chief of The Maine Wire.

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